- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $835.47 / $835.47 / $7,047.00
| Facility | | $835.47 | $835.47 | $7,047.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.37 / $2,322.81 / $7,921.39
| Facility | | $914.37 | $2,322.81 | $7,921.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,842.87 / $2,613.42 / $6,286.94
| Facility | | $1,842.87 | $2,613.42 | $6,286.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,498.12 / $2,389.30 / $4,950.35
| Facility | | $1,498.12 | $2,389.30 | $4,950.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,204.05 / $1,696.46 / $2,940.00
| Facility | | $1,204.05 | $1,696.46 | $2,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,755.00 / $2,872.00 / $4,241.00
| Facility | | $1,755.00 | $2,872.00 | $4,241.00 |